Choose Your Quack Before You Crack

I prefer women. I find them more genuinely caring. I certainly find them easier to talk to. Perhaps it is just that the majority of my better experiences are with women psychiatrists and my worst experiences are certainly with male doctors. Maybe it is just my natural preference. It doesn't matter why—in the States you get to choose, and my preference is a woman psychiatrist.

You need to get to know your doctor while you are well. Likewise your doctor needs to get to know you as you normally are. Come a major episode you are putting yourself in her hands. You need to know that she is going to do the right thing. You need to discuss what the right thing is before you become ill.

Strange as it may seem this is really hard to do. It is all but impossible to find yourself a good psychiatrist in advance of an episode. I am not certain why this is. But they just don't take kindly to you telling them of your own diagnosis. They don't take kindly to being told what they need to do when you become ill. Perhaps it is my lack of bedside manner. Perhaps it is my itinerant nature—I should have made arrangements for my notes to be transferred. Perhaps there is a "Doubting Thomas" effect—a need to put their own finger in the wound—a need to make their own diagnosis. And you can't diagnose a basket weaver in advance of an episode.

Stranger still, it can be pretty hard convincing a doctor you don't already know that you are entering the early stages of a manic episode. Perhaps they are expecting the men in white coats to deposit a raving lunatic. No doubt about that one. But if the role of the men in white coats is played by a work colleague and the lunatic is fully-dressed, lucid, and coherent, the best you'll get from a doctor that doesn't already know you is a mild sedative. A mild sedative is about as much use to your average basket weaver as a bag of M & M's—and the ones without the nuts at that.

Another paradox: it's hard to choose a good doctor before you are in need of one. But if you don't know the doctor beforehand, it is hard to catch the episode early; it is hard to make sure they do the right thing.

I'm sorry, you can't go home until you're better.